Hello Dr. Rijhwani,I think you will remember me, Donna XXXXXXX the last session closed so I had to pay again to follow up with you. If you don't see it in your records I had a positive XXXXXXX Titer 1:320, Speckled. I received the completed results of the XXXXXXX panel and here they are as follows: Thyroid Peroxidase Abs 9.5 Normal Range <35, Serology, Rheumatoid Factor Negative, SS-A IgG Autoantibodies <11.00 normal <11.00, SS-B IgG Autoantibodies <11.00 normal <11.00, Scl-70 IgG Autoantibodies <11.00 normal <11.00, C3 Complement 105, normal 90-180, C4 Complement 17, normal 16-47, nRNP/SMIgG Autobodies <11.00 normal <11.00, XXXXXXX Screen (Symphony) 0.2 Less than 0.7 Negative, dsDNA 0.4 IU/ml less than 10 IU/ml negative, Ribosomal P Protein Autoantibodies <11.00 normal <11.00. My doctor said everything was normal and she also said on this test my XXXXXXX was negative XXXXXXX Screen (Symphony) 0.2, is that correct and if so how does one test show a positive and another negative? I did notice my C4 Complement was 17 which is within range the normal range being 16-47, it is on the long end is that anything to be concerned or followed up on? Also are the test you mentioned I should have included in here, you did mention about a ENA and I don't see that here? What would a ENA test show? I also would like to remind you I have no symptoms. I appreciate your professional opinion, thank you very much.Sincerely grateful,Donna XXXXXXX

Thank you for your response. So there is no concern then that my C4 complement was at 17 and the low range being 16-49? Also was this last report consider a negative because the XXXXXXX Screen (Symphony) was 0.2 and less than 0.7 is negative? Is that the same as a negative ANA? The test just read different as they were done at different labs. Thank you kindly for answering my questions I truly appreciate your help until I get my appt. with my Rheumatologist.
Sincerely grateful,
XXXXX

Answered by Dr. Shruti Rijhwani 1 hour later

answer Id 204765; conversation id 204279

Dear XXXXXXX ,

No, until it lies in the normal range there is no concern for being worried.

Yes, your XXXXXXX by symphony method that probably uses ELISA is negative. XXXXXXX can be done by other methods also like by immunofloresence . Both the methods are equally good but we generally prefer IFA for screening purposes.

Hello Dr. XXXXXXX
I received some more lab results today that I would like to get your opinion on, they are as follows: CRP hs Inflam/Infect <0.02 mg/dL Units, they do not provide a reference range, does this mean my value was less than 0.02? I did read some where there should not be any CRP in the blood, is that true? I also read 1-3 is normal, I did not get to talk to my Rhematologist about it yet, I won't be able to see her until next week so if you could clarify this for me I would greatly appreciate it. I also read CRP has to do with inflammation, heart, and of course one article had to mention lympohoma and cancers, could my value be any reflection of those I mentioned, particular cancer? My Sed Rate (Westergren) was 8 within normal Ref. Range 0-30. Why don't they give a Reference Range on the CRP? Again my main concern is the CRP <0.02mg/dL Units? I do run and exercise however I did not exercise the morning of these test, I did not want to have any false positives or negatives as I know exercise can effect these test, I did workout the day before with a 23 hour rest before taking the test. Thank you kindly for all your help.
Sincerely grateful,
XXXXX

Answered by Dr. Shruti Rijhwani 16 hours later

answer Id 204767; conversation id 205134

Dear XXXXXXX ,

Thanks for getting back .

CRP which is C-Reactive Protein is an acute inflammatory marker that can be raised in any infection or any other condition. It is not specific for any condition. And I think in your case it is not raised .

Usually the range is mentioned always. It can be checked otherwise by its normal range for units in which they have given the result .

Rest your ESR is normal that is raised in many autoimmune conditions . Well i don't see any reason to be worried.

Hello and thank you once again. I know you said in my case my CRP is not raised but I don't quite understand what you meant by "Usually the range is mentioned always. It can be checked otherwise by its normal range for units in which they have given the result." I am sorry I don't understand what you mean, please tell me is my CRP less than 0.02 and is there not suppose to be any CRP in the blood at all and why is it they did not give a normal range on the report? I have read CRP hs less than 0.02 is normal and I have read there should be no CRP in the blood at all, which is correct? I also read that CRP hs is more sensitive than a regular CRP. Thank you for your responses.
Sincerely grateful,
XXXXX

Answered by Dr. Shruti Rijhwani 9 hours later

answer Id 204769; conversation id 205371

Dear XXXXXXX

Thanks for getting back.

Well I meant that generally when a test is done by a lab they always menton its normal range in result . Sometimes in different countries differebt units are used for a particular test like you said CRP in mg/dl . So I said that if you know the units normal range can be checked for it if it is not mentioned in the test report.

Both statements are right . Ideally there is no CRP in blood because it rises during inflammatory conditions but in our body somewhere some type of inflammatory process is going on so it may lead to minimal levels .

hS CRP is generally significant in cardiac conditions not but in your case it is normal so there is no need to worry.

Dear Dr XXXXXXX
In what country do you practice medicine? I still don't understand what you are saying as far as when you said, "So I said if you know the units normal range can be checked for it if it is not mentioned in the test report." I do not understand that statement. I see on my report it says CRP hs <0.02, does that mean mine is less than 0.02, that would be a minimal amount correct? Also you said in our bodies some type of inflammation is going so will most people have a minimal amount such as <0.02? Thank you again, I do appreciate all your help.
Sincerely grateful,
XXXXX

Answered by Dr. Shruti Rijhwani 1 hour later

answer Id 204771; conversation id 205578

Dear XXXXXXX

Thanks for getting back .

I practise in India XXXXXXX

Lets just concentrate on your report which is definitely normal .So you need not worry about anything else . Yes even when we get reports of normal people not suffering from any kind of infection or anything they will not have zero value some minimal value is reported in quantitative tests . Dont worry you will be fine soon.